水疗结合下肢康复机器人对早期脑卒中患者步态重建的影响
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摘要
目的:观察水疗结合下肢康复机器人对早期脑卒中患者下肢运动控制、步态及能量损耗的影响。方法:将80例脑卒中患者随机分为对照组和干预组各40例,对照组予以常规康复治疗,干预组则配合水疗及下肢机器人训练,治疗12周后采用Fugl-Meyer下肢运动功能评分量表评定综合运动功能、步行生理消耗指数测定身体能量损耗、步态分析系统评测步态参数(步宽、步速、步长)。结果:治疗后,干预组Fugl-Meyer评分、步态参数、步行生理消耗指数改善程度均显著优于对照组(P<0.01)。结论结论:水疗结合下肢康复机器人训练可有效加强早期脑卒中患者的下肢运动控制,促进步态重建,降低身体能量损耗。
Objective: To observe the influence of hydrotherapy combined with rehabilitation robot for lower limbs on motion control, gait and energy expenditure of stroke patients at early stage. Methods: 80 cases of stroke patients were randomly divided into control group(n=40) and intervention group(n=40), the control group treated with conventional rehabilitation treatment while intervention group combined with hydrotherapy and rehabilitation robot, then evaluated the comprehensive motor function with Fugl-Meyer assessment for lower limbs, energy expenditure with Walking Physiological Consumption Index and gait parameters(stride width, leg speed, step length) by gait analysis system after 12 weeks of treatment. Results: After treatment, the improvement of Fugl-Meyer score, gait parameters and Walking Physiological Consumption Index of intervention group were significantly better than those of control group(P<0.01). Conclusion: The therapy of hydrotherapy combined with rehabilitation robot for lower limbs can effectively enhance the motion control of stroke patients at early stage, promote their gait reconstruction and decrease energy expenditure.
Objective: To observe the influence of hydrotherapy combined with rehabilitation robot for lower limbs on motion control, gait and energy expenditure of stroke patients at early stage. Methods: 80 cases of stroke patients were randomly divided into control group(n=40) and intervention group(n=40), the control group treated with conventional rehabilitation treatment while intervention group combined with hydrotherapy and rehabilitation robot, then evaluated the comprehensive motor function with Fugl-Meyer assessment for lower limbs, energy expenditure with Walking Physiological Consumption Index and gait parameters(stride width, leg speed, step length) by gait analysis system after 12 weeks of treatment. Results: After treatment, the improvement of Fugl-Meyer score, gait parameters and Walking Physiological Consumption Index of intervention group were significantly better than those of control group(P<0.01). Conclusion: The therapy of hydrotherapy combined with rehabilitation robot for lower limbs can effectively enhance the motion control of stroke patients at early stage, promote their gait reconstruction and decrease energy expenditure.
引文
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[20]熊友红,何小辉,唐巧萍,等.MOTOmed智能训练结合水疗改善痉挛型脑瘫患儿步行能力的临床研究[J].中国康复医学杂志,2014,29(5):481-482.
[21]Trueblood PR.Partial body weight treadmill training in persons with chronic stroke[J].NeuroRehabilitation,2001,16(3):141-153.
[22]Eversden L,Maggs F,Nightingale P,et al.A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis[J].BMC Musculoskelet Disord,2014,(8):23.
[2]周末,林爱翠.脑卒中患者早期康复需求情况的调查研究[J].中国康复医学杂志,2015,30(8):820-821.
[3]徐光青,兰月,黄东锋,等.运动想象对脑卒中患者偏瘫步态和步行能力的影响[J].中国康复医学杂志,2010,25(10):942-952.
[4]韩慧,沈丽娟,刘海兵,等.脑卒中患者不同时机早期步行训练效果比较[J].护理与康复.2015,14(2):161-163.
[5]高春华,黄晓琳,黄杰,等.下肢康复机器人训练对早期脑卒中偏瘫患者下肢功能的影响[J].中国康复医学杂志,2014,29(4):351-353.
[6]王轶钊,黄力平,张琳瑛,等.水中运动训练对恢复期脑卒中患者下肢肌肉力量和步行能力的影响[J].中国康复医学杂志,2013,28(10):929-933.
[7]王莉,戴朝秦.水中强化步行训练对脑卒中偏瘫患者步行能力恢复的影响[J].中国康复医学杂志,2014,29(1):76-78.
[8]饶明俐.中国脑血管病防治指南[M].北京:人民卫生出版社,2007.
[9]恽晓平.康复疗法评定学[M].北京:华夏出版社,2009:395-396.
[10]周美琴,朱晓芸,史惟,等.特殊学校脑瘫儿童步行能量消耗测定的重测信度及测量误差[J].中国康复理论与实践,2012,18(2):152-154.
[11]长水,毕胜.步行速度在脑卒中患者运动功能恢复评定中的价值[J].中国康复理论与实践,2014,9(11):680-681.
[12]王宁华.脑卒中康复的优化运动技巧练习:肌力训练[J].中华物理医学与康复杂志,2013,30(11):790.
[13]赵雅宁,马素慧,李建民,等.步态训练机器人对脑卒中偏瘫患者步行功能的影响[J].中国康复理论与实践,2013,19(1):57-59.
[14]吴华,顾旭东,傅建明,等.下肢康复机器人系统对卒中偏瘫患者运动功能的影响[J].中华医学杂志,2014,92(37):2628-2631.
[15]王伟,李岩,吴华,等.下肢康复机器人训练对急性脑卒中患者下肢运动功能的影响[J].中华物理医学与康复杂志,2013,35(6):464-467.
[16]刘畅,郄淑燕,王寒明,等.下肢康复机器人对脑卒中偏瘫患者下肢运动功能与步行能力的效果[J].中国康复理论与实践,2017,23(6):696-670.
[17]许光旭,顾绍钦,孟殿怀,等.下肢痉挛偏瘫患者的步行效率[J].中国组织工程研究与临床康复,2014,13(11):2166-2169.
[18]吴琼,丛芳,周红俊,等.水中平板步行训练在脊髓损伤患者康复中的应用[J].中国康复理论与实践,2010,16(3):216-218.
[19]王俊,黄犇,杨占宇,等.水中平板步行训练对脑卒中患者步行能力改善的研究[J].中国康复医学杂志,2015,30(7):695-695.
[20]熊友红,何小辉,唐巧萍,等.MOTOmed智能训练结合水疗改善痉挛型脑瘫患儿步行能力的临床研究[J].中国康复医学杂志,2014,29(5):481-482.
[21]Trueblood PR.Partial body weight treadmill training in persons with chronic stroke[J].NeuroRehabilitation,2001,16(3):141-153.
[22]Eversden L,Maggs F,Nightingale P,et al.A pragmatic randomised controlled trial of hydrotherapy and land exercises on overall well being and quality of life in rheumatoid arthritis[J].BMC Musculoskelet Disord,2014,(8):23.